Video 5:26
Healthy Lives

Louisa Rebgetz talks to Professor Sir Michael Marmot who has been investigating how living conditions, education, work, access to health care and life opportunities impact on people's health.

Transcript

LOUISA REBGETZ, PRESENTER: For the past thirty years Professor Sir Michael Marmot has been investigating how living conditions, education, work, access to health care and life opportunities impact on people's health. Professor Marmot is in the Northern Territory to deliver a lecture entitled Fair Society, Healthy Lives. While here he's visited a number of remote communities. I spoke with him earlier today and asked him what he'd seen during his visit.

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: Problems with early child development, problems with education, lack of jobs, so it's not just having good jobs it's having any job at all. Having enough money to lead a healthy life, problems of housing and community development and problems with alcohol, tobacco and diet, other determinants. So I saw all of that. You can't help but be surprised if you come from Sydney and Adelaide or even Darwin and then go to Gunbalanya or to Tiwi, and you think "Am I in the same country?".

LOUISA REBGETZ: That disempowerment, how does that have an impact on someone's health?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: If you're feeling disempowered so you go into a community where individuals feel disempowered and you say "you know, you really shouldn't smoke", "do me a favour - I'm going to die at 50 or I'm going to be in prison. Why on earth should I care about smoking?". Data from Canada, British Colombia, suggests when you look at first nation communities, aboriginal communities in Canada there more empowered the communities are; land claim participation, control over their health and education and other services, the more empowered communities are the lower the youth suicide rate.

LOUISA REBGETZ: The Federal Government here, their latest major policy to try to close the gap for Indigenous Australians has been an intervention style approach. Do you think that approach works to improve people's health?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: It's very difficult if you're sitting in Canberra or Sydney or Melbourne to know how best to address these issues. You can get the principals right of what really matters, and I would argue those six areas - early child development, education, employment, et cetera, would apply very much in the Northern Territory but to get it right in practice and what people were saying to me was there were aspects of the intervention that they liked and there were aspects that they found extremely distasteful. The disempowerment is extremely distasteful.

LOUISA REBGETZ: Is it a factor of more additional money or is it a factor or good will?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: Money always helps, no question about it, money always helps. Putting enough money into the programs always helps. Money by itself is not enough, money by itself can actually do harm if you get it wrong. So an examples about that, people in the Northern Territory no better than I do but for example promoting a welfare culture is by itself not a good thing.

LOUISA REBGETZ: In a country like Australia, in a rich country like Australia, does it surprise you that there such a big gap between the life expectancy of Indigenous and non-indigenous Australians?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: Well I said this morning that in the Scottish city of Glasgow there was a 28-year gap in life expectancy among men living in the most deprived area of Glasgow compared with those living in the most affluent. Even in London there's a 17-year gap between most and least deprived life expectancy so I'm not shocked by the magnitude. I mean this is a fantastic country and a fantastically wealthy country and a country that's put real effort into improving lives for its people. That's wonderful, and yet the Indigenous population has missed out on that.

LOUISA REBGETZ: You've worked extensively with the World Health Organisation and delivering the 'Closing the Gap in a Generation' report. How does Australia rate within that?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: If you look at the average Australia does wonderfully well. One of our key messages is we've got to go beyond averages and look at the distribution of health. On Indigenous versus non-indigenous Australia lags behind New Zealand, Australia lags behind Canada, Australia lags behind the United States.

LOUISA REBGETZ: Looking ahead and having been to those communities - what do you think the future holds there, are you hopeful?

PROFESSOR SIR MICHAEL MARMOT, INTERNATIONAL INSTITUTE FOR SOCIETY & HEALTH: I'm not underestimating the entrenched nature of the problems but knowing the principles, having some impressive people who are taking leadership and having the resources from government potentially and one hopes the goodwill of government potentially, means that one can't be anything other than hopeful.